Our Naughty Nurse takes vital signs in Buffalo

Ah, the Buffalo Bills. They aren't mentioned with the all-time greats of American sporting futility alongside the Los Angeles Clippers, Seattle Mariners or Toronto Maple Leafs, but they have been serving on the front lines of futility for the better part of five decades.

This past decade has been the worst of the five – no playoff appearances, no offense, no identity, and usually no hope. Worse, the Bills have avoided rock bottom, a status that has kept them in a vicious cycle of sub-mediocrity that they seem unlikely and even unwilling to break out of.

It's as if the NFL is collectively the Bills' abusive boyfriend, and they're too scared to get the help they need for a better tomorrow.

Do they have a chance at becoming relevant again? Only if they're willing to take bold steps forward in one of the strongest divisions in the league.

Buffalo

The 2010 storyline: The Bills entered the season with little hope of making the playoffs and fulfilled the prophecy nicely – but they also played just a bit better than you thought they would over the second half of the season. You can blame their tough schedule for some of the struggles, but it's not getting any easier in the AFC East going forward.

Statistical curiosity of 2010: The Bills scored 17 points or fewer in 11 of their 16 games, but put up 30 vs. New England, 34 vs. Baltimore and 49 vs. Cincinnati.

Best game of 2010: 37-34 loss at Baltimore in Week 7. When you pile up 514 yards on the road against the Ravens' defense, it's a pretty special achievement for any team, let alone a 4-12 squad.

Worst game of 2010: 38-14 loss vs. Jets in Week 4. The Bills were handed an unplayable schedule by the NFL, and this game was right in the thick of it. Not only did the Bills play all of the NFL's final four by season's end, they played six playoff teams in the first half of the season when they were still figuring out who their quarterback and tailback were going to be. Ouch.

The loss to the Jets was as bad as it gets – they were on the wrong end of the turnover battle (2-0) and still managed to get outgained two-to-one. The Jets rushed 49 times for 273 yards, the kind of stats you expected to see in Buffalo when the "Electric Company" was paving holes in the D for O.J. Simpson 35 or 40 years ago.

Strength: Offensive Hogs. With everything on this team, success was relative – this was the worst team in the league in our Quality Stats, but you have to chalk up some of that to their brutal schedule.

The offensive line had been a consistent bottom-ranker on our index the past half-decade, so a No. 18 spot for 2010 is a rare feather in head coach Chan Gailey's cap. Interior linemen Andy Levitre, Eric Wood and Geoff Hangartner are a nice building block, but the Bills are still in need of top-level offensive tackles. Too bad they couldn't retain the services of Jason Peters, last seen getting picked for the Pro Bowl with the Eagles.

Weakness: Defensive Hogs. Buffalo was a one-man show up front in 2010, and last time we checked you needed seven up front to play in the NFL. Defensive tackle Kyle Williams wound up as a Pro Bowl replacement, but the Bills' indecision between the 3-4 and 4-3 kept them on their heels all year long.

It's not as if the Bills haven't been trying to get better here. From 2006 to 2010, they drafted six players for the front seven with picks in the top 75 overall: DT Torell Troup, DE Alex Carrington, DE/LB Aaron Maybin, DE Chris Ellis, LB Paul Pozluzny and DT John McCargo. That's a lot of draft power for a grand total of four sacks in 2010.

Maybin in particular has been a spectacular bust; it seems almost impossible that a No. 11 overall pick would be unable to crack the rotation on one of the worst defensive fronts in the league, but there you have it. The Bills would happily trade Maybin for more-noted bust Vernon Gholston of the Jets, who at least saw regular action on a very good New York front.

With a team that did as poorly across the board as Buffalo, it's worth noting some of their other obvious weaknesses. They were shockingly bad at taking care of the ball, giving it away 39 times on the season. Oddly enough, they turned it over 25 times in their final eight games and still managed to go 4-4. Had they matched that total during their gauntlet run in the first half of the season, they would have had a record of minus-3 and 11 instead of a more garden variety 0-8.

General off-season strategy/overview: Everybody has a soft spot for the Bills. They were loveable losers when they lost four straight Super Bowls, and they're lovable losers when they string together an endless barrage of non-winning seasons.

But where does it end? The Patriots and Jets are top-10 teams, and the Dolphins appear to be a couple of players away from joining them. The Bills, though, seem to have nothing going for them. They haven't hit a home run with a first-round pick since CB Antoine Winfield in 1999 (or maybe even Nate Clements in 2001). But like all of their good draft picks, they exited elsewhere as soon as they were able. Winfield, in particular, had his best years in Minnesota. They've got a placeholder coach in Gailey and a placeholder quarterback in Ryan Fitzpatrick.

They do, however, have a load of money available to spend, and the No. 3 pick in this draft. What should they do with it? While no one has them taking a quarterback in their mocks (which are usually a mockery of reality anyway), the Bills need to take Cam Newton at No. 3 and start him from Day 1. It's a gamble. But it will get people talking about the Buffalo Bills. Add a tackle in the second round, sign some front-seven guys in free agency, and all of a sudden there's something to be excited about in Buffalo.

Fitzpatrick provides some nice insurance at QB, but he had a career year and it still wasn't all that good. He's a backup. Newton could be a bust, but what do the Bills have to lose? Put him with a pretty decent group of skill guys (C.J. Spiller, Fred Jackson, Lee Evans, Steve Johnson), and you've got a chance to do something this team hasn't done in a decade: Build an identity.

Will they do it? Probably not. They'll stand pat, take a defensive player, trot out Fitzpatrick for another year and shoot for moral victories. Yay.

Totally premature 2011 diagnosis: They were probably lucky to win four games in 2010, and will be lucky to do it again this year unless they follow our Cam Newton blueprint. But the likely best-case scenario is this: A half-season of replacement players, Doug Flutie comes out of retirement to cross the picket lines, the Bills go 8-0 ... and sneak into the playoffs at 10-6 when the real dudes come back.